Polyp Removal: Hysteroscopic Polypectomy in Bengaluru

Key takeaways

• Endometrial and cervical polyps are common growths that are almost always benign.
• They can cause irregular bleeding, spotting after sex or difficulty conceiving, or no symptoms at all.
• Hysteroscopic polypectomy removes the polyp under direct vision, with no abdominal incision.
• Every removed polyp is sent for histopathology to confirm it is benign.
• Polyps found after menopause or causing bleeding are generally removed.

What are endometrial and cervical polyps?

Polyps are soft, finger-like overgrowths of tissue. Endometrial polyps grow from the lining inside the uterus, while cervical polyps grow from the canal of the cervix and are often visible during a speculum examination.

Polyps are linked to oestrogen and are more common in the 40s and around menopause, in women taking tamoxifen, and in those with obesity, high blood pressure or PCOS. They range from a few millimetres to several centimetres, and there may be one or several.

Common symptoms

• Bleeding or spotting between periods
• Heavy or irregular periods
• Bleeding after intercourse
• Bleeding after menopause
• Difficulty conceiving, or repeated IVF failure
• Many polyps are found incidentally on a scan

Who needs polyp removal?

Removal is recommended for polyps that cause symptoms, polyps found after menopause, polyps larger than about 1–1.5 cm, and polyps in women trying to conceive or preparing for IVF.

Small polyps without symptoms in younger women can sometimes be watched, because some resolve on their own. Dr. Divya will advise based on your age, symptoms, scan findings and fertility plans.

How is a polyp diagnosed?

A transvaginal ultrasound, ideally just after the period, often shows an endometrial polyp. A saline infusion scan (sonohysterography) gives a clearer view. Diagnostic hysteroscopy confirms the diagnosis and often allows the polyp to be removed in the same sitting. Cervical polyps are usually seen directly during a speculum examination.

What to expect: step by step

1. Consultation and scan: your symptoms are reviewed and the ultrasound is assessed.
2. Pre-procedure checks: blood tests, a pregnancy test and an anaesthesia assessment. The procedure is ideally scheduled just after your period ends.
3. Admission: you arrive fasting on the day; the procedure is done as day care.
4. Hysteroscopy: under short general or spinal anaesthesia (or sometimes local anaesthesia in the outpatient setting), a slim hysteroscope is passed through the vagina and cervix. Saline gently expands the uterus so the lining can be seen on screen.
5. Polypectomy: the polyp is removed at its base using fine instruments, a tissue removal device or an electrosurgical loop. The procedure usually takes 15–30 minutes.
6. Recovery and discharge: you rest for a few hours and go home the same day.
7. Results: the histopathology report is discussed at your follow-up visit, usually within 1–2 weeks.

Small cervical polyps can often be removed in the clinic by gently twisting them off, a quick procedure that needs no anaesthesia.

What results can you realistically expect?

Hysteroscopic polypectomy is highly effective at relieving abnormal bleeding caused by polyps, and most women notice an improvement in their next cycles.

Polyps can recur over the years, so report any new abnormal bleeding.

What are the risks and side effects?

Hysteroscopic polypectomy is a low-risk procedure, but no surgery is risk-free.

• Cramping and light bleeding for a few days (expected)
• Infection (uncommon)
• Perforation of the uterus (rare)
• Fluid overload from the distension fluid (rare and monitored)
• Risks related to anaesthesia

Recovery and aftercare

Most women return to work and normal activities in 1–2 days. Expect mild cramps, which settle with simple painkillers, and light spotting or watery discharge for up to a week. Avoid intercourse, tampons and swimming for about a week or as advised. Call if you develop fever, foul-smelling discharge, heavy bleeding or severe pain. Women preparing for IVF can usually proceed with treatment from the next cycle.

What does polyp removal cost in Bengaluru?

The cost of hysteroscopic polypectomy depends on:

• pre-procedure scans and blood tests;
• whether it is done in the clinic or the operating theatre;
• the type of anaesthesia;
• the instruments or tissue removal system used;
• day-care charges and the histopathology test.

You will receive an estimate after your consultation, and day-care hysteroscopy is commonly covered by health insurance.

When to see a doctor

Make an appointment if you have bleeding between periods, bleeding after sex, periods that have become heavier, or any bleeding after menopause, even a single episode of spotting. Also see a doctor if you have been trying to conceive without success.

Why choose Dr. Divya Venugopalan?

Dr. Divya Venugopalan is a gynaecologist and fertility specialist with more than 14 years of experience. She holds a DNB in Obstetrics and Gynaecology, a Fellowship in Minimal Access Surgery (FMAS) for hysteroscopic and laparoscopic surgery, and a Fellowship in Reproductive Medicine (FRM). For women trying to conceive, polyp removal can be planned around fertility treatment such as IVF.

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